Çocukluk çağında oksipital deşarjların saptandığı epilepsi tanılı hastaların klinik, laboratuvar ve görüntüleme özelliklerinin incelenmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İzmir Bakırçay Üniversitesi Lisansüstü Eğitim Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmamızda öncelikli amacımız, oksipital deşarjların saptandığı epilepsi tanılı hastaların demografik bulgularını ortaya koymak ve uzun dönem izlem sonuçlarını değerlendirmektir. İkincisi ise hastalar arasında ilk 36 ay içinde tedaviye yanıt veren hastalar (Grup 1) ile tedaviye 36 ayda yanıt vermeyen hastaları (Grup 2) karşılaştırıp prognozu etkileyen faktörleri saptamaktır. Gereç ve Yöntem: Bu retrospektif çalışma, 2018-2023 yılları arasında çocukluk çağı oksipital deşarjların saptandığı epilepsi (COVE, POLE, SeLEAS, semptomatik, sınıflandırılamayan) tanısı konmuş 84 hastayı kapsamaktadır. Hastaların demografik verileri (epilepsi tanı yaşı, bugünkü yaşı, cinsiyeti, ebeveyninde akrabalık varlığı), klinik ve laboratuvar özellikleri, elektroensefalografi (EEG) ve manyetik rezonans görüntüleme (MRG) sonuçları incelenmiştir. İstatistiksel analizler, JASP ve Jamovi yazılımları kullanılarak gerçekleştirilmiştir. Gruplar arası tedaviye yanıtın değerlendirilmesinde Odds Ratio (OR) ve çok değişkenli lojistik regresyon analizi kullanılmıştır. Bulgular: Hastaların %32'si (27 hasta) Grup 1'de, %68'i (57 hasta) ise Grup 2'de bulunmaktaydı. Grup 2'deki hastaların EEG ve MRG incelemelerinde yapısal beyin anormallikleri daha sık görülmüştür. Ayrıca bu grup hastalar, yüksek oranda psikiyatrik komorbidite ve sosyal uyum sorunları yaşamaktadır. Gruplar tanı yaşları açısından karşılaştırıldığında Grup 2'deki hastalarda tanı yaşının anlamlı derecede küçük (p=0,003), mental retardasyon (MR) oranının ise daha yüksek olduğu (p=0,05) bulunmuştur. Epilepsi izlem süresi, Grup 2'deki hastalarda anlamlı derecede daha uzundur (p<0,001). Çalışmaya aldığımız hastaların 20'sinde (%23,8) ek sistemik hastalık varlığı saptanmış olup, hiçbirinin iyileşmediği görülmüştür (p=0,018). Sonuç: Çalışmamız, çocukluk çağında oksipital deşarjların saptandığı epilepsi tanılı hastaların tedavisinin 36 aydan uzun sürdüğünü göstermiş olup tanı esnasında tedavi süresi ile ilgili öngörü sağlaması açısından önemlidir. Tedaviye 36 ayda yanıt vermeyen vakalar, multidisipliner yaklaşımlar ve bireyselleştirilmiş tedavi stratejileri gerektirmektedir. Anahtar Sözcükler: Oksipital lob kaynaklı epilepsi, tedavi süresi, prognostik faktörler.
Objective: Primary aim in our study is to reveal the demographic findings of patients diagnosed with epilepsy in whom occipital discharges are detected and to report the long-term follow-up results. Our secondary aim is to find prognostic factors by comparing patients who responded to treatment within the first 36 months (Group 1) and patients who did not respond to treatment in 36 months (Group 2). Materials and Methods: This retrospective study includes 84 patients diagnosed with epilepsy with childhood occipital discharges (COVE, POLE, SeLEAS, symptomatic, unclassifiable epilepsy) between 2018 and 2023. The patients' demographic data (epilepsy diagnosis age, current age, gender, parental consanguinity), clinical and laboratory characteristics, electroencephalography (EEG) and magnetic resonance imaging (MRI) results were examined. Statistical analysis was performed using JASP and Jamovi software. Odds Ratio (OR) and multivariate logistic regression analysis were used to evaluate the response to treatment between groups. Results: 32% (27 patients) of the patients were in Group 1, and 68% (57 patients) were in Group 2. Structural brain abnormalities were seen more frequently in EEG and MRI examinations in Group 2. In addition, this group of patients experiences high rates of psychiatric comorbidity and social adaptation problems. When the groups were compared in terms of age at diagnosis, it was found that the age at diagnosis was significantly younger in patients in Group 2 (p=0,003) and the rate of mental retardation (MR) was higher (p=0,05). Epilepsy follow-up period was significantly longer in patients in Group 2 (p<0,001). Additional systemic disease was detected in 20 (23,8%) of the patients we included in the study, and none of them recovered (p=0,018). Conclusion: Our study has shown that the treatment of patients diagnosed with epilepsy in whom occipital discharges were detected in childhood lasts longer than 36 months and is important in terms of providing insight into the duration of treatment at the time of diagnosis. Cases that do not respond to treatment within 36 months require multidisciplinary approaches and individualized treatment strategies.
Objective: Primary aim in our study is to reveal the demographic findings of patients diagnosed with epilepsy in whom occipital discharges are detected and to report the long-term follow-up results. Our secondary aim is to find prognostic factors by comparing patients who responded to treatment within the first 36 months (Group 1) and patients who did not respond to treatment in 36 months (Group 2). Materials and Methods: This retrospective study includes 84 patients diagnosed with epilepsy with childhood occipital discharges (COVE, POLE, SeLEAS, symptomatic, unclassifiable epilepsy) between 2018 and 2023. The patients' demographic data (epilepsy diagnosis age, current age, gender, parental consanguinity), clinical and laboratory characteristics, electroencephalography (EEG) and magnetic resonance imaging (MRI) results were examined. Statistical analysis was performed using JASP and Jamovi software. Odds Ratio (OR) and multivariate logistic regression analysis were used to evaluate the response to treatment between groups. Results: 32% (27 patients) of the patients were in Group 1, and 68% (57 patients) were in Group 2. Structural brain abnormalities were seen more frequently in EEG and MRI examinations in Group 2. In addition, this group of patients experiences high rates of psychiatric comorbidity and social adaptation problems. When the groups were compared in terms of age at diagnosis, it was found that the age at diagnosis was significantly younger in patients in Group 2 (p=0,003) and the rate of mental retardation (MR) was higher (p=0,05). Epilepsy follow-up period was significantly longer in patients in Group 2 (p<0,001). Additional systemic disease was detected in 20 (23,8%) of the patients we included in the study, and none of them recovered (p=0,018). Conclusion: Our study has shown that the treatment of patients diagnosed with epilepsy in whom occipital discharges were detected in childhood lasts longer than 36 months and is important in terms of providing insight into the duration of treatment at the time of diagnosis. Cases that do not respond to treatment within 36 months require multidisciplinary approaches and individualized treatment strategies.
Açıklama
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases, Occipital lobe-derived epilepsy, treatment duration, prognostic factors.
